Intratumoral follicular regulatory T cells curtail anti-PD-1 treatment efficacy.

Immune-checkpoint blockade (ICB) has shown remarkable clinical success in boosting antitumor immunity. However, the breadth of its cellular targets and specific mode of action remain elusive. We find that tumor-infiltrating follicular regulatory T (TFR) cells are prevalent in tumor tissues of several cancer types. They are primarily located within tertiary lymphoid structures and exhibit superior suppressive capacity and in vivo persistence as compared with regulatory T cells, with which they share a clonal and developmental relationship. In syngeneic tumor models, anti-PD-1 treatment increases the number of tumor-infiltrating TFR cells. Both TFR cell deficiency and the depletion of TFR cells with anti-CTLA-4 before anti-PD-1 treatment improve tumor control in mice. Notably, in a cohort of 271 patients with melanoma, treatment with anti-CTLA-4 followed by anti-PD-1 at progression was associated with better a survival outcome than monotherapy with anti-PD-1 or anti-CTLA-4, anti-PD-1 followed by anti-CTLA-4 at progression or concomitant combination therapy.

Kidney temperature during living donor kidney transplantation is associated with short-term measured glomerular filtration rate - a prospective study.

The duration of warm ischaemia time is associated with short- and long-term kidney transplant function. A quick rise in graft temperature is reported during the vascular anastomosis. This study was initiated to gain insight into the effect of graft temperature on short-term transplant function. From 2013 to 2015, data of living donor kidney transplant recipients were prospectively collected. At set intraoperative time points, the graft temperature was measured using a noncontact infrared thermometer. Primary endpoint was measured glomerular filtration rate (mGFR) at 3- and 6-month post-transplantation. Univariable and multivariable associations were identified using linear regression analyses. Multivariable analysis included models with donor, recipient and procedure characteristics. We evaluated 152 patients, 83 (55%) were male, mean ±SD age was 50.3 ± 13.4 years, and 79 (52%) were pre-emptively transplanted. In univariable analysis graft temperature, after 10 min of warm ischaemia was significantly associated with 3- and 6-month mGFR, ß -0.22 (95% CI -0.39 to -0.04, P = 0.01) and ß-0.22 (95% CI: -0.44 to -0.01, P = 0.04). The association remained significant in multivariable models. An independent association between kidney graft temperature and 3- and 6-month mGFR was identified. This association opens up the opportunity to further investigate the clinical impact of kidney rewarming during transplantation.

Kidney temperature course during living organ procurement and transplantation.

Little is known about the actual kidney graft temperature during the 2nd warm ischemia time (WIT2). We aimed to determine the actual temperature course of the WIT2, with emphasis on the 15 °C metabolic threshold. Data of 152 consecutive adult living donor kidney transplantations were collected. The mean WIT2 was 41.3 ± 10.1 (SD) minutes with a temperature of 5.4 °C at baseline which gradually increased to 13.7, 17.4, and 20.2 °C after 10, 20, and 30 min, respectively. The percentage of kidneys with a temperature of 15 °C or higher was 81.2% after 20 min and 97.5% after 30 min. Duration of surgery (95% CI: -0.017 to -0.002, P = 0.02), multiple veins (95% CI: 0.0003-2.720, P = 0.05) and WIT2 (95% CI: 0.016-0.099, P = 0.006) were associated with a rapid temperature increase. No correlation could be determined between a rapid temperature rise and diminished graft function. This study showed a rapid increase in kidney temperature during WIT2, wherein the 15 °C threshold was reached within 20 min in more than 80% of the patients.

Fibroblast activation and senescence in oral cancer.

There is now compelling evidence that the tumour stroma plays an important role in the pathogenesis of cancers of epithelial origin. The pre-eminent cell type of the stroma is carcinoma-associated fibroblasts. These cells demonstrate remarkable heterogeneity with activation and senescence being common stress responses. In this review, we summarise the part that these cells play in cancer, particularly oral cancer, and present evidence to show that activation and senescence reflect a unified programme of fibroblast differentiation. We report advances concerning the senescent fibroblast metabolome, mechanisms of gene regulation in these cells and ways in which epithelial cell adhesion is dysregulated by the fibroblast secretome. We suggest that the identification of fibroblast stress responses may be a valuable diagnostic tool in the determination of tumour behaviour and patient outcome. Further, the fact that stromal fibroblasts are a genetically stable diploid cell population suggests that they may be ideal therapeutic targets and early work in this context is encouraging.

Systematic review and meta-analysis of immunohistochemical prognostic biomarkers in resected oesophageal adenocarcinoma.

BACKGROUND: Oesophageal adenocarcinoma (OAC) is one of the fastest rising malignancies with continued poor prognosis. Many studies have proposed novel biomarkers but, to date, no immunohistochemical markers of survival after oesophageal resection have entered clinical practice. Here, we systematically review and meta-analyse the published literature, to identify potential biomarkers. METHODS: Relevant articles were identified via Ovid medline 1946-2013. For inclusion, studies had to conform to REporting recommendations for tumor MARKer (REMARK) prognostic study criteria. The primary end-point was a pooled hazard ratio (HR) and variance, summarising the effect of marker expression on prognosis. RESULTS: A total of 3059 articles were identified. After exclusion of irrelevant titles and abstracts, 214 articles were reviewed in full. Nine molecules had been examined in more than one study (CD3, CD8, COX-2, EGFR, HER2, Ki67, LgR5, p53 and VEGF) and were meta-analysed. Markers with largest survival effects were COX-2 (HR=2.47, confidence interval (CI)=1.15-3.79), CD3 (HR=0.51, 95% CI=0.32-0.70), CD8 (HR=0.55, CI=0.31-0.80) and EGFR (HR=1.65, 95% CI=1.14-2.16). DISCUSSION: Current methods have not delivered clinically useful molecular prognostic biomarkers in OAC. We have highlighted the paucity of good-quality robust studies in this field. A genome-to-protein approach would be better suited for the development and subsequent validation of biomarkers. Large collaborative projects with standardised methodology will be required to generate clinically useful biomarkers.

Tumour-infiltrating lymphocytes predict for outcome in HPV-positive oropharyngeal cancer.

BACKGROUND: Human papillomavirus (HPV)-positive oropharyngeal cancer (OPSCC) is associated with improved survival compared with HPV-negative disease. However, a minority of HPV-positive patients have poor prognosis. Currently, there is no generally accepted strategy for identifying these patients. METHODS: We retrospectively analysed 270 consecutively treated OPSCC patients from three centres for effects of clinical, pathological, immunological, and molecular features on disease mortality. We used Cox regression to examine associations between factors and OPSCC death, and developed a prognostic model for 3-year mortality using logistic regression analysis. RESULTS: Patients with HPV-positive tumours showed improved survival (hazard ratio (HR), 0.33 (0.21-0.53)). High levels of tumour-infiltrating lymphocytes (TILs) stratified HPV-positive patients into high-risk and low-risk groups (3-year survival; HPV-positive/TIL(high)=96%, HPV-positive/TIL(low)=59%). Survival of HPV-positive/TIL(low) patients did not differ from HPV-negative patients (HR, 1.01; P=0.98). We developed a prognostic model for HPV-positive tumours using a 'training' cohort from one centre; the combination of TIL levels, heavy smoking, and T-stage were significant (AUROC=0·87). This model was validated on patients from the other centres (detection rate 67%; false-positive rate 5.6%; AUROC=0·82). INTERPRETATION: Our data suggest that an immune response, reflected by TIL levels in the primary tumour, has an important role in the improved survival seen in most HPV-positive patients, and is relevant for the clinical evaluation of HPV-positive OPSCC.

Concordance of the SHEA-IDSA severity classification for Clostridium difficile infection and the ATLAS bedside scoring system in hospitalized adult patients.

PURPOSE: The Society for Healthcare Epidemiology of America and Infectious Diseases Society of America (SHEA-IDSA) guidelines for the treatment of Clostridium difficile infection (CDI) recommend initial treatment of CDI based on disease severity. This severity definition has not been validated or evaluated based on clinical outcomes. The ATLAS scoring system is a validated tool useful in predicting treatment response and mortality in CDI. The main purpose of this study is to evaluate the concordance of the ATLAS scoring system and the SHEA-IDSA staging for CDI severity. METHODS: This was a retrospective study which included hospitalized patients with confirmed CDI. Bivariate analyses compared baseline demographics and clinical information between patients with nonsevere and severe CDI based on the SHEA-IDSA criteria for CDI severity. Kappa scores were calculated to compare the concordance of the two scoring systems in defining CDI severity. Sensitivity and specificity of the ATLAS scoring system to determine CDI severity were calculated using the SHEA-IDSA criteria as the reference standard. RESULTS: Sixty-four patients met inclusion criteria. Of those, 62.5% were classified as mild to moderate CDI, 25% were severe, uncomplicated, and 12.5% were severe, complicated based on SHEA-IDSA criteria. In the bivariate analyses, ATLAS score breakpoints of ≥ 4, ≥ 5, and ≥ 6 revealed moderate agreement with the SHEA-IDSA classification for severity. The sensitivities and specificities for ATLAS scores in predicting CDI severity ranged from 58.3 to 87.5, and 67.5-87.5%, respectively. CONCLUSION: The ATLAS score may be useful in evaluating CDI severity and determining drug therapy selection.

First Report of Wheat mosaic virus Infecting Wheat in Western Australia.

In eastern Australia, there have been several as yet unconfirmed reports of Wheat mosaic virus (WMoV) infecting wheat (3). WMoV, previously known as High plains virus (HPV), is transmitted by the wheat curl mite (WCM, Aceria tosichella). It is often found in mixed infections with Wheat streak mosaic virus (WSMV), also transmitted by WCM (2,3). WSMV was first identified in Australia in 2003 (3). In October 2012, stunted wheat plants with severe yellow leaf streaking were common in a field experiment near Corrigin in Western Australia consisting of nine wheat cultivars. These symptoms were also common in two commercial crops of wheat cv. Mace near Kulin. Leaf samples (one per plant) from each location were tested by ELISA using specific antiserum to WMoV (syn. HPV 17200, Agdia, Elkhart, IN). At the field experiment, 20 leaf samples were collected at random from each wheat plot (4 replicates) and tested individually by ELISA. WMoV incidence was 5% for cv. Yipti, 16% for cvs Emu Rock, Wyalkatchem and Mace, 22% for cvs. Corack, Fortune, Calingiri, and Magenta, and 55% for cv. Cobra. From the two commercial wheat crops, 100 leaf samples were collected at random from each and tested by ELISA. WMoV incidence was 2 and 4%. In addition, 50 leaf samples of Hordeum leporinum (barley grass) and 20 of Lolium rigidum (annual ryegrass) were collected and tested by ELISA. WMoV incidence was 2% in H. leporinum, but 0% in L. rigidum. Infected H. leporinum plants were symptomless. Symptomatic wheat leaf samples from both sites were tested by RT-PCR using WMoV specific primers designed from its RNA3 sequence (1). The PCR products (339 bp) were sequenced and lodged in GenBank (Accession Nos KC337341 and KC337342). WMoV isolates from Corrigin (WA-CG12) and Kulin (WA-KU12) had identical sequences. When the nucleic acid sequences of WA-CG12 and WA-KU12 were compared with those of the three other WMoV isolates on GenBank, they had 100% nucleotide sequence identity with a Nebraska isolate (U60141), and 99.7% identity to two United States sweet corn isolates (AY836524 and AY836525). Ten symptomatic wheat plants were collected from each location, transplanted into pots and leaf samples tested individually for WMoV and WSMV (07048, Loewe, Germany) by ELISA. All were infected with both viruses and infested with WCM. WCM-infested glumes (>10 WCM/glume) were placed on the leaf sheaths of 60 wheat plants cv. Calingiri (35 with WA-CG12 and 25 with WA-KU12) and 13 sweet corn plants cv. Snow Gold (WA-CG12 only). In addition, 20 wheat and 10 sweet corn plants were left without infested glumes to be uninoculated controls. All 60 WCM-inoculated wheat plants became stunted with severe leaf streaking. When leaf samples from each plant were tested by ELISA 18 to 30 days later, both viruses were detected. WMoV was detected in all 13 WCM-inoculated sweet corn plants and WSMV in two of them. Plants with WMoV alone initially had short chlorotic leaf streaks that subsequently combined, causing broad streaks. These are typical WMoV symptoms for sweet corn (1). No symptoms developed and no virus was detected in any of the uninoculated wheat or sweet corn control plants. The WMoV nucleotide sequence obtained from an infected sweet corn plant was identical to those of WA-CG12 and WA-KU12. To our knowledge, this is the first confirmed report of WMoV presence in Australia. References: (1) B. S. M. Lebas et al. Plant Dis. 89:1103, 2005. (2) D. Navia et al. Exp. Appl. Acarol. 59:95, 2013. (3) J. M. Skare et al. Virology 347:343, 2006.

Optimal skin simulant for ballistic testing.

An extensive literature review, combined with practical experience of forensic testing, has identified several concerns regarding existing studies into skin simulants. These can be summarised as arising due to human skin being a highly complex, multi-layered and anisotropic material whose mechanical properties depend on many factors such as age and gender of the host. In many studies (and papers) essential information is missing. Although there is some parallelism between the studies, the reported energy density at perforation is very inconsistent (a function of the natural variation of skin properties alluded to above) and differs from 0,113 J/mm2 [1] to 0,239 J/mm2 [2]. Which is, in fact, a more than 100 % variation. Such a variation is arguably insufficient to enable accurate replication with a single simulant material. Combined with the missing common agreement about the energy density threshold between countries, laboratories and researchers, this analysis clearly identifies the need for an adjustable and / or customizable skin simulant. To-date, the most often used simulation material for human skin in ballistic testing is 'Chrome crusted cow hide' [3]. However, this is a natural material and, consequently therefore, inevitably physically variable in nature - both inter and intra hide. Ballistic tests on 10 chrome crusted cow hides using 4,5 mm BB's gave v50% ranging from 113 m/s to 200 m/s, an uncontrolled variability for forensic experiments. Hence, the authors examined a skin analogue that could be produced in-house, enabling tailoring to match the desired properties, and with improved consistency. To this end, a thin, 4 mm thick, layer of gelatine (30 - 45 wt%, increasing per 1 wt%) was studied. The ballistic resistance of the gelatine skin analogue was compared to the v50%'s published values in literature, with good agreement found as the gelatine concentration was varied. In comparison to the chrome crusted cow hides this suggests that this relatively simple and accessible approach has potential to provide a more consistent standard.

ST2 in patients with severe aortic stenosis and heart failure.

BACKGROUND: ST2 is a circulating biomarker that is well established for predicting outcome in heart failure (HF). This is the first study to look at ST2 concentrations in optimally treated patients with stable but significant left ventricular systolic dysfunction (LVSD) compared to patients with severe aortic stenosis (AS). METHODS: Two cohorts were retrospectively studied: 94 patients undergoing transcatheter aortic valve implantation for severe AS (63 with normal ejection fraction [EF] and 31 with reduced EF), and 50 patients with severe LVSD from non-valvular causes. ST2 pre-procedural samples were taken, and repeated again at 3 and 6 months. Patients were followed-up for 2 years. Data was analyzed using SPSS software. RESULTS: Baseline concentrations of soluble ST2 did not differ significantly between the HF group and AS group with normal EF (EF ≥ 50%). However, in the AS group with a low EF (EF < 50%) ST2 concentrations were significantly higher that the HF group (p = 0.009). New York Heart Association class IV HF, baseline N-terminal pro-B-type natriuretic peptide and gender were all independent predictors of soluble ST2 (sST2) baseline concentrations. CONCLUSIONS: Raised ST2 concentrations in the context of severe AS may be a marker for subclinical or clinical left ventricular dysfunction. More research is required to assess its use for assessment of prognosis and response to treatment.

Validity of Winkler's mattress model for thin elastomeric layers: beyond Poisson's ratio.

Winkler's mattress model is often used as a simplified model to understand how a thin elastic layer, such as a coating, deforms when subject to a distributed normal load: the deformation of the layer is assumed proportional to the applied normal load. This simplicity means that the Winkler model has found a wide range of applications from soft matter to geophysics. However, in the limit of an incompressible elastic layer the model predicts infinite resistance to deformation, and hence breaks down. Since many of the thin layers used in applications are elastomeric, and hence close to incompressible, we consider the question of when the Winkler model is appropriate for such layers. We formally derive a model that interpolates between the Winkler and incompressible limits for thin elastic layers, and illustrate this model by detailed consideration of two example problems: the point-indentation of a coated elastomeric layer and self-sustained lift in soft elastohydrodynamic lubrication. We find that the applicability (or otherwise) of the Winkler model is not determined by the value of the Poisson ratio alone, but by a compressibility parameter that combines the Poisson ratio with a measure of the layer's slenderness, which itself depends on the problem under consideration.

Secondary structure of ribosomal RNA.

Infrared spectra were obtained for 16S and for 23S ribosomal RNA's in D(2)O solutions. The percentage of each base in the paired and unpaired regions of the RNA was determined from the spectra. The secondary structures of 16S and 23S ribosomal RNA's (from Escherichia coli) are significantly different from each other and are also different from those of yeast ribosomal RNA, formylmethionyl-transfer RNA, and the anticodon fragment of this transfer RNA.

Secondary structure of histones and DNA in chromatin.

Laser Raman spectroscopy indicates that the inner histones which are bound to DNA in chromatin or in isolated nu bodies are similar in conformation to the inner histones which are dissociated from DNA in high-salt solutions. This structure contains, on the average, 51+/-5% alpha-helix and no substantial beta-sheet conformation. It is proposed that the protein core of the nu body has a high alpha-helix content.

On differences in the equation-of-state for a selection of seven representative mammalian tissue analogue materials.

Tissue analogues employed for ballistic purposes are often monolithic in nature, e.g. ballistic gelatin and soap, etc. However, such constructs are not representative of real-world biological systems. Further, ethical considerations limit the ability to test with real-world tissues. This means that availability and understanding of accurate tissue simulants is of key importance. Here, the shock response of a wide range of ballistic simulants (ranging from dermal (protective/bulk) through to skeletal simulant materials) determined via plate-impact experiments are discussed, with a particular focus on the classification of the behaviour of differing simulants into groups that exhibit a similar response under high strain-rate loading. Resultant Hugoniot equation-of-state data (Us-up; P-v) provides appropriate feedstock materials data for future hydrocode simulations of ballistic impact events.

Structural basis of polyamine-DNA recognition: spermidine and spermine interactions with genomic B-DNAs of different GC content probed by Raman spectroscopy.

Four genomic DNAs of differing GC content (Micrococcus luteus, 72% GC; Escherichia coli, 50% GC; calf thymus, 42% GC; Clostridium perfringens, 27% GC) have been employed as targets of interaction by the cationic polyamines spermidine ([H(3)N(CH(2))(3)NH(2)(CH(2))(4)NH(3)](3+)) and spermine ([(CH(2))(4)(NH(2)(CH(2))(3)NH(3))(2)](4+)). In solutions containing 60 mM DNA phosphate (approximately 20 mg DNA/ml) and either 1, 5 or 60 mM polyamine, only Raman bands associated with the phosphates exhibit large spectral changes, demonstrating that B-DNA phosphates are the primary targets of interaction. Phosphate perturbations, which are independent of base composition, are consistent with a model of non-specific cation binding in which delocalized polyamines diffuse along DNA while confined by the strong electrostatic potential gradient perpendicular to the helix axis. This finding provides experimental support for models in which polyamine-induced DNA condensation is driven by non-specific electrostatic binding. The Raman spectra also demonstrate that major groove sites (guanine N7 and thymine C5H(3)) are less affected than phosphates by polyamine-DNA interactions. Modest dependence of polyamine binding on genome base composition suggests that sequence context plays only a secondary role in recognition. Importantly, the results demonstrate that polyamine binding has a negligible effect on the native B-form secondary structure. The capability of spermidine or spermine to bind and condense genomic B-DNA without disrupting the native structure must be taken into account when considering DNA organization within bacterial nucleoids or cell nuclei.

Translational aspects in targeting the stromal tumour microenvironment: from bench to bedside.

Solid tumours comprise, not only malignant cells but also a variety of stromal cells and extracellular matrix proteins. These components interact via an array of signalling pathways to create an adaptable network that may act to promote or suppress cancer progression. To date, the majority of anti-tumour chemotherapeutic agents have principally sought to target the cancer cell. Consequently, resistance develops because of clonal evolution, as a result of selection pressure during tumour expansion. The concept of activating or inhibiting other cell types within the tumour microenvironment is relatively novel and has the advantage of targeting cells which are genetically stable and less likely to develop resistance. This review outlines key players in the stromal tumour microenvironment and discusses potential targeting strategies that may offer therapeutic benefit.

The potential role of human kidney cortex cysteine proteinases in glomerular basement membrane degradation.

(1) The degradation of glomerular basement membrane and some of its constituent macromolecules by human kidney lysosomal cysteine proteinases has been investigated. Three cysteine proteinases were extracted from human renal cortex and purified to apparent homogeneity. These proteinases were identified as cathepsins B, H and L principally by their specific activities towards Z-Arg-Arg-NHMec, Leu-NNap and Z-Phe-Arg-NHMec, respectively, and their Mr on SDS-polyacrylamide gel electrophoresis under reducing conditions. (2) Cathepsins B and L, at acid pH, readily hydrolysed azocasein and degraded both soluble and basement membrane type IV and V collagen, laminin and proteoglycans. Their action on the collagens was temperature-dependent, suggesting that they are only active towards denatured collagen. Cathepsin L was more active in degrading basement membrane collagens than was cathepsin B but qualitatively the action of both proteinases were similar, i.e., at below 32 degrees C the release of an Mr 400,000 hydroxyproline product which at 37 degrees C was readily hydrolysed to small peptides. (3) In contrast, cathepsin H had no action on soluble or insoluble collagens or laminin but did, however, hydrolyse the protein core of 35S-labelled glomerular heparan sulphate-rich proteoglycan. (4) Thus renal cysteine proteinases form a family of enzymes which together are capable of degrading the major macromolecules of the glomerular extracellular matrix.

Raman spectra and conformational structures of Fab mu and (Fc)5 mu fragments of cryoglobulin IgM-kappa McE.

Raman spectra have been obtained on aqueous solutions of the following human immunoglobulins: IgM-kappa McE, IgG-kappa Ger, IgM-kappa WSm and IgG-lambda Gui. The former two species exhibit the property of cryoprecipitation. Comparison of the spectra shows that all immunoglobulins have similar secondary structures, predominantly of the beta-sheet type. Fab mu and (Fc)5 mu fragments of IgM-kappa McE also yield Raman spectra which indicate closely similar secondary structures. Minor differences among the spectra can be explained by differences in amino acid compositions of the respective proteins.

Hydrogen exchange dynamics of the P22 virion determined by time-resolved Raman spectroscopy. Effects of chromosome packaging on the kinetics of nucleotide exchanges.

We describe the application of laser Raman spectroscopy to probe hydrogen isotope exchange dynamics of nucleic acid and protein constituents in a double-stranded DNA virus, the icosahedral bacteriophage P22. The Raman dynamic method employs a dialysis flow cell to control D2O efflux into an H2O solution of the virus sample while the rates of deuterium exchange of protons in the viral nucleic acid and protein molecules are measured spectrophotometrically in real time. The method provides structural and kinetic information about three different and distinct classes of exchangeable protons of the native virion: (1) labile imino (NH) and amino (NH2) protons of the bases which participate in Watson-Crick hydrogen bonding in the packaged genome; (2) pseudolabile purinic (8CH) protons that line the major groove of packaged P22 DNA; and (3) main-chain amide (NH) protons of viral subunits comprising the shell that encapsidates the DNA. The results obtained on P22 demonstrate that interchange of aqueous solvent with the virion interior is rapid and complete. We find that while labile protons of packaged DNA exchange rapidly, most amide protons in capsid subunits are resistant to solvent-catalyzed exchange. Further, stereospecific retardation of exchange is observed for major-groove protons of the packaged P22 genome. The quantitative measurements can be summarized and interpreted as follows. (1) Imino and amino protons of all bases in packaged P22 DNA exchange more rapidly (approximately 2-fold faster) than the corresponding protons in unpackaged P22 DNA. Remarkably, packaging actually accelerates labile imino and amino hydrogen exchanges of the viral DNA, an effect which can be attributed to selective stabilization in the packaged chromosome of a base-pair open state (breathing model). (2) Conversely, purine 8CH exchange rates in packaged P22 DNA are significantly retarded in comparison to those of unpackaged P22 DNA. The observed 8CH exchange retardation effects are similar for both adenine and guanine residues, indicating that they do not originate from purine-specific interactions but probably reflect steric shielding of the major groove of packaged DNA from free access to solvent. This effect is likely distributed throughout the 43,400 base-pair genome. (3) Only a small population (approximately 15 to 20%) of subunit amide protons exchanges within the time frame of complete exchange of all protons of packaged P22 DNA. Complete exchange of the capsid is not achieved even after several months of incubation at 40 degrees C.(ABSTRACT TRUNCATED AT 400 WORDS)